﻿<!DOCTYPE html>
<html lang="en">
<#include "../common/common-head.html"/>
<body class="gray-bg top-navigation">
<div id="wrapper">
    <div id="page-wrapper" class="gray-bg">
    <#include "../common/common-menu.html">
        <div class="wrapper wrapper-content">
            <div class="row white-bg" style="padding: 18px 0">
                <div class="col-xs-3"></div>
                <div class="col-xs-6">
                    <form class="form-horizontal m-t" action="${basePath}/register/update" method="post">
                        <input type="hidden" name="id" value="${register.id}">
                         <@formEdit labels=["病历号","姓名","社保号","联系电话","职业"] names=["no","name","sebao","phone","zhiye"]  model=register></@formEdit>
                        <@formEditSel label="证件类型" name="cardtype" valueMap={"身份证":"身份证","护照":"护照"} model=register></@formEditSel>
                        <@formEdit labels=["证件号"] names=["card"] model=register></@formEdit>
                        <@formEditSel label="性别" name="sex" valueMap={"男":"男","女":"女"} model=register></@formEditSel>
                        <@formEditNum label="年龄" name="age" model=register> </@formEditNum>
                        <@formEditSel label="初复诊" name="type" valueMap={"初诊":"初诊","复诊":"复诊"} model=register></@formEditSel>
                        <@formEditSel label="所挂科室" name="dep" valueMap={"骨科":"骨科","眼科":"眼科","耳鼻喉科":"耳鼻喉科","妇科":"妇科","儿科":"儿科"} model=register></@formEditSel>

                        <@formEdit labels=["备注"] names=["remark"] model=register></@formEdit>
                        <div class="form-group has-info">
                            <label class="control-label col-sm-2">指定医生:</label>
                            <div class=" col-sm-8">
                                <select class="form-control input-sm col-sm-2" name="docid">
                                <#list doctorList as item>
                                    <option value="${item.id}"
                                            <#if item.id == register.docid>selected</#if>>${item.name}</option>
                                </#list>
                                </select>
                            </div>
                        </div>
                        <div class="form-group">
                            <div class="col-xs-8 col-xs-offset-3">
                                <button class="btn btn-primary" type="submit">提交</button>
                            </div>
                        </div>
                    </form>
                </div>
            </div>
        </div>
    </div>
</div>
</body>
</html>

